Illegal abortion is responsible for up to half of maternal deaths and consumes a large proportion of health resources in many developing countries, particularly in Africa and Latin America. The legal situation of abortion in a country does not influence the abortion rate, but illegality is associated with a much greater risk of complications and death. To make abortion legal is not enough. Access to safe abortion strongly depends on the capacity and willingness of physicians and the health system to provide safe services, which sometimes are made available in spite of restrictive laws. The abortion rate will drop and the safety of the procedure will improve, parallel to the position women occupy in a given society, and to the level of recognition of their sexual and reproductive rights. The medical profession, and FIGO in particular, has a great role to play in implementing initiatives that will reduce the consequences of illegal abortion for women and society.